Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Dakota (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Black Hills Special Services Cooperative (NPI 1578600417)

Field	Value
Entity Type	Organization
Organization	Black Hills Special Services Cooperative
Address	2885 Dickson Drive
City	Sturgis
State	SD
ZIP	57785
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 31, 2007

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only operator: there is no Medicare billing on file and lifetime Medicaid revenue is $33.7M. The absence of Medicare activity indicates the organization’s clinical and billing focus is squarely on Medicaid-covered developmental-disability waiver services rather than fee-for-service Medicare lines.

Revenue is highly concentrated in three waiver-related codes: T2016, T2020, and S0281 together account for 95.5% of the provider’s Medicaid revenue. Specifically, T2016 accounts for $21.2M (62.9%), T2020 for $8M (23.8%), and S0281 for $3M (8.9%), which makes the business model dependent on a small set of per-diem habilitation and care-coordination services.

The service mix points to a core operation centered on residential and day habilitation plus care coordination: T2016 is billed as Habilitation, residential, waiver (per diem) and T2020 is Day habilitation, waiver (per diem), while S0281 covers medical home program comprehensive care coordination. The combination of large per-diem payments for residential habilitation (T2016: 5.3K claims, $3998 avg paid/claim) and high-volume day habilitation (T2020: 7.5K claims, $1068 avg paid/claim) indicates an integrated residential/day habilitation footprint with supporting care-planning services.

Competitive standing in-state is modest rather than dominant across the top codes: T2016 ranks #14 of 21 providers (35th percentile), T2020 ranks #9 of 20 providers (58th percentile), and S0281 ranks #11 of 21 providers (50th percentile), each characterized as typical or unremarkable volume for the code. These ranks suggest BLACK HILLS SPECIAL SERVICES COOPERATIVE is a routine participant in the South Dakota waiver market without leading market share for any single top revenue-driving code.

Operational profile nuance: although T2020 has the highest claim count (7.5K claims) and T2016 has fewer claims (5.3K), T2016’s much larger avg paid/claim ($3998) drives the majority of revenue ($21.2M). This imbalance—high per-diem value for residential habilitation versus higher volume but lower per-claim payment for day habilitation—means revenue sensitivity is concentrated in per-diem rates and utilization patterns for residential habilitation.

Several smaller codes illustrate typical, low-concentration activity consistent with a waiver services provider: examples include T2025 (4.4K claims, $105 avg paid/claim, $465.6K), T2014 (938 claims, $404 avg paid/claim, $379K), and T2018 (1.5K claims, $225 avg paid/claim, $329K). These smaller lines each contribute well under 2% of total Medicaid revenue and rank in the mid to lower state percentiles, reinforcing that this entity’s financial profile is dominated by the top three codes.

Tenure and organizational stability: the provider’s NPI was enumerated on 2007-01-31 (~19 years ago), indicating long-standing participation in Medicaid waiver delivery in the region. For payers and analysts, that longevity combined with the concentrated revenue mix suggests an established local operator whose financial performance will be particularly sensitive to state waiver reimbursement policy and any changes to per-diem payments for residential habilitation and day services.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	5,290	$4,000	$21.2M
T2020	Day habilitation, waiver; per diem	7,490	$1,070	$8M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	6,090	$490	$3M
T2025	Waiver services; not otherwise specified (nos)	4,430	$110	$465.6K
T2014	Habilitation, prevocational, waiver; per diem	940	$400	$379K
T2018	Habilitation, supported employment, waiver; per diem	1,460	$230	$328.9K
T2019	Habilitation, supported employment, waiver; per 15 minutes	580	$280	$163.3K
T2017	Habilitation, residential, waiver; 15 minutes	180	$600	$110K
T2028	Specialized supply, not otherwise specified, waiver	1,040	$60	$64.7K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Dakota Distribution

Black Hills Special Services Cooperative — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	14	20	6,880	$1,660	$31.6M
T2020	Day habilitation, waiver; per diem	9	20	7,340	$500	$8.9M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	11	20	6,090	$420	$3M
T2025	Waiver services; not otherwise specified (nos)	12	20	5,410	$180	$1.9M
T2017	Habilitation, residential, waiver; 15 minutes	11	10	470	$270	$437.9K
T2018	Habilitation, supported employment, waiver; per diem	10	20	1,510	$80	$433.9K
T2014	Habilitation, prevocational, waiver; per diem	11	20	1,210	$130	$410.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	7	20	480	$90	$288.6K
T2028	Specialized supply, not otherwise specified, waiver	16	30	910	$50	$169.8K

Nearby Providers

Other providers in the same ZIP code as Black Hills Special Services Cooperative, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$737.5K
Black Hills Special Services	SD	Case Management Agency	$0	$551.6K
Action For The Betterment Of The Community	SD	Community/Behavioral Health Agency	$0	$538.1K
Black Hills Counseling LLC	SD	Mental Health Counselor	$0	$491.4K
Black Hills Special Services Cooperative	SD	Case Management Agency	$0	$471.3K
Northern Hills Eye Care, Prof. L.L.C.	SD	Optometrist	$0	$428.4K
Sturgis Chiropractic, P.C.	SD	Chiropractor	$0	$277.3K
City Of Sturgis	SD	Land Ambulance	$174.7K	$35K
Meade School District 46 1	SD	Local Education Agency (LEA)	$0	$196.9K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$162.3K

Black Hills Special Services Cooperative — Billing Profile & Reimbursement Data

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Black Hills Special Services Cooperative — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References